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Cheyenne County Consultative Visit Report

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Cheyenne County Consultative Visit Report Page | 1 Table of Contents Introduction and Project Overview ................................................................................. 2 Introduction and Project Overview ................................................................................. 3 County Geography and Demographics ..........................................................................4 Emergency Medical and Trauma Services Providers ................................................... 5 Chaffee County Emergency Medical Services ............................................................ 5 Buena Vista Volunteer Fire Department .................................................................. 5 Chaffee County Fire Protection District .................................................................. 6 EagleMed ...................................................................................................... 6 Salida Fire Department ..................................................................................... 7 South Arkansas Fire Protection District ................................................................... 7 Chaffee County Search and Rescue (North) .............................................................. 8 Chaffee County Search and Rescue (South) .............................................................. 8 Monarch Mountain Ski Patrol ............................................................................... 8 Heart of the Rockies Regional Medical Center ........................................................... 9 Chaffee County Communications Center ................................................................ 10 Analysis of Chaffee County EMS System Elements…..…………………………….…….………11 Legislation and Regulation ................................................................................ 11 System Finance .............................................................................................. 14 Human Resources ........................................................................................... 31 Medical Direction ........................................................................................... 35 Clinical Care ................................................................................................. 36 Education Systems .......................................................................................... 40 Public Access ................................................................................................ 44 Communications ............................................................................................ 46 Information Systems ........................................................................................ 47 Public Education ............................................................................................ 50 Prevention ................................................................................................... 52 Mass Casualty ............................................................................................... 54 Evaluation .................................................................................................... 55 Integration of Health Services ............................................................................ 58 Summary of Recommendations .......................................................................................... 63 Appendix A: 2014 EMS Statistics .......................................................................................... 76 Appendix B: List of Stakeholders Interviewed ................................................................. 78 Appendix C: Chaffee County Service Map ........................................................................ 79 Appendix D: Assessment Team Biographical Information ........................................ 80 Tim Dienst ................................................................................................... 80 Arlene Harms ................................................................................................ 80 Tad Rowan. .................................................................................................. 80 Scott Sholes .................................................................................................. 81 Matt Skwiot .................................................................................................. 81 Matt Concialdi ............................................................................................... 81 Eric Schmidt ................................................................................................. 82 References ........................................................................................................ 82 Emergency Medical and Trauma Services Consultative Visit Chaffee County, Colorado Page | 2 Executive Summary In August 2015, the Colorado Department of Public Health and Environment, along with five EMS and trauma services experts, performed a consultative visit at the request of the Chaffee County Board of Commissioners. The purpose of the visit was to review and evaluate the components of the EMS and trauma system in order to provide recommendations for system improvement and enhancement. The Chaffee County EMS and trauma system includes Chaffee County Emergency Medical Services, Buena Vista Volunteer Fire Department, Chaffee County Fire Protection District, Salida Fire Department, South Arkansas Fire Protection District, EagleMed, Flight For Life, Chaffee County Search and Rescue (North and South), Chaffee County Communications Center, Monarch Mountain Ski Patrol and Heart of the Rockies Regional Medical Center. American Medical Response is called to provide interfacility transport when requested by Heart of the Rockies Regional Medical Center. Chaffee County is nestled around four mountain passes: Monarch, Cottonwood, Trout Creek and Poncha, creating an isolated rural environment that poses challenges to the EMS and trauma system. Mutual aid can be 30 to 90 minutes away depending upon weather and resource availability. The pre- visit survey showed that the stakeholders rated the overall effectiveness of the system as above average. It was evident that the community is supportive of the ambulance service and the commissioners are willing do what it takes to sustain EMS. In addition, the dedication that the community members have to the various emergency services is to be commended and, if directed appropriately, will fuel long term growth and sustainability. Chaffee County is a well-run EMS service with top of the line personnel and equipment. Long-term sustainability of the service is in question recently since the primary funding sources, user fees and federal PILT funds, have become less reliable. The county is being proactive in looking for more sustainable funding through a small sales tax initiative on the ballot in November 2015. Another challenge of the current model is that a full time paramedic working a regular shift rotation is also serving as EMS director. This diminishes the amount of time available to effectively run the operation. With a more stable funding source, Chaffee County EMS could implement a full time EMS director position, allowing the agency to continue its growth and enhance the services provided to the community. One link missing in the system due to funding constraints is the ability to provide prompt interfacility ground transportation out of the hospital. These services are currently being contracted through a private provider based on the Front Range, which can cause an 8 to 24 hour delay in patient transport. The county emergency services as a whole has many dedicated paid and volunteer service members, but because a multitude of emergency services agencies with disparate levels of resources are spread throughout the county, not all of them tend to work together as well as they might. By creating a cohesive working emergency services unit focused on the good of the community, Chaffee County has the ability to excel as an integrated healthcare system. This report provides a list of suggested short-, medium- and long-term recommendations for system improvement and enhancement. These suggested recommendations are found within the various sections of the report as well as listed in the appendix at the conclusion of the analysis report. A map of the county with EMS and fire department resource locations is provided in the appendix along with the 2014 Chaffee County EMS response data. Emergency Medical and Trauma Services Consultative Visit Chaffee County, Colorado Page | 3 Introduction and Project Overview In February 2015, the Board of County Commissioners of Chaffee County requested grant funding from the Colorado Department of Public Health and Environment (department) to provide an assessment and review of the county’s emergency medical and trauma services system. The department awarded system improvement funding in July 2015 to support the consultation. Under Colorado law, the Board of County Commissioners is the ground ambulance licensing authority as defined by C.R.S. § 25-3.5-301 and C.R.S. § 30-11-107(q). The primary EMS agency in Chaffee County is Chaffee County Emergency Medical Services. Fire services in Chaffee County are provided by Buena Vista Volunteer Fire Department, Chaffee County Fire Protection District, Salida Fire Department and South Arkansas Fire Protection District. The sole hospital in the area is the Heart of the Rockies Regional Medical Center, a Level
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